Enrolls providers new to Privia with all commercial health plans specific to the market.
Updates and maintains provider enrollment status in credentialing system, CredentialStream.
Performs follow up with health plans according to designated timeline, until Provider is PAR.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices. Privia Health consists of scalable cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Coordinate end-to-end provider credentialing and re-credentialing processes with commercial and government payers.
Support payer contracting activities, including data collection, application submission, and follow-up.
Maintain accurate provider credentialing files in accordance with regulatory and accreditation standards.
Sunrise Group builds the future of sleep health by combining breakthrough technology with expert care. Backed by more than $50M, their team of 100+ clinicians, engineers, and operators across the US and Europe is dedicated to making high-quality sleep care accessible to everyone.
Managing the credentialing, payer enrollment, and provider onboarding processes for physicians and advanced practice providers.
Ensuring providers are credentialed, enrolled, and maintained with commercial and government payers in a timely and accurate manner.
Maintaining provider records, monitoring credentialing deadlines, and coordinating with payers and providers.
Modena Health (MH) and Modena Allergy & Asthma (MAA) are leading and rapidly growing medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona, and ambitious plans for national expansion. They are physician-led, hospitality-focused, and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.
Deliver an outstanding customer experience by supporting inquiries across phone, email, text, and chat.
Manage high-complexity insurance workflows and inbound support requests to collect documentation.
Partner with clinical, scheduling, and operations teams to ensure accurate treatment plan alignment and continuity of care.
Expressable is a virtual speech therapy practice that aims to transform care delivery and expand access to high-quality services. Since 2019, they serve thousands of clients with a focus on parent-focused intervention and an e-learning platform with home-based learning modules.
Interpret medical rules, regulations, fee schedules, and edits that payers post.
Understand and manipulate payer data to build federal, state, and commercial coding and financial tables.
Maximize the efficiency and use of product solutions by properly maintaining payer specific edits.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. They operate across a range of markets and have an amazing team of 25,200 people in 32 countries.
Perform outbound calls to engage patients about the benefits of Salvo’s program and tech-enabled services.
Enroll patients in Salvo’s program and schedule an initial virtual nurse visit to onboard patients.
Assist patients in understanding the cost of the program, including insurance coverage and financial responsibilities.
Salvo Health offers virtual care to patients at community specialty care practices, focusing on chronic gut health and metabolic conditions. The company has raised a Series A investment round and aims to provide continuous, interdisciplinary wraparound care.
Serve as the primary contact for CM/UM programs and operational questions related to the MyCare Platform.
Build relationships with provider offices through outreach and timely follow-up, resolving issues within defined turnaround times.
Educate providers on submission requirements, documentation, timelines, and available CM/UM resources.
Personify Health created a personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while improving health outcomes.
Manage end-to-end delegated credentialing operations across an assigned portfolio of payors.
Prepare, coordinate, and execute both pre-delegation and annual credentialing audits.
Build and deliver reporting packages for submission to delegated entities & payors.
Grow Therapy is a company that serves as a trusted partner for therapists growing their practice, and patients accessing high-quality care. They are powered by technology as a three-sided marketplace that empowers providers, augments insurance payors, and serves patients with over ten thousand therapists and hundreds of thousands of clients across the country.
Verify patient insurance coverage, eligibility, and benefits prior to services.
Obtain required prior authorizations from payers for services, procedures, or medications.
Monitor and track pending authorizations; follow up to prevent delays.
Prompt is revolutionizing healthcare with modern software for rehab therapy businesses. As the fastest-growing company in the therapy EMR space, Prompt is setting a new standard in healthcare technology with a team of exceptionally talented individuals.
Facilitate telephonic enrollment by presenting benefits and assisting prospects with completing enrollment.
Maintain knowledge of Medicare, Medi-Cal, and SCAN benefits through required certifications and training.
Initiate follow-up calls and manage prospect requests and CRM work lists to meet sales goals.
SCAN is a nonprofit health organization dedicated to keeping older adults healthy and independent. Serving over 500,000 people across six states with $8 billion in annual revenue, SCAN has a values-driven culture focused on compassion, innovation, and integrity.
Drive the creation of payer-specific marketing materials.
Serve as the primary owner for a portfolio of payer products and specialized payer projects.
Report on product and campaign performance and provide recommendations for product enhancement.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. They are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Help network development and contracting goals within designated geographies.
Develop and refine local contracting strategies to drive provider participation in Medicare Advantage, Direct Contracting and other value-based initiatives.
Address and resolve any concerns raised by providers and effectively communicate those solutions to internal stakeholders.
Clover Health is a Medicare Advantage and Prescription Drug plan changing how healthcare is delivered by combining data with human empathy to keep members healthier. They are passionate and mission-driven individuals, working together to solve the most complicated problem in the world: healthcare.
Primarily responsible for making outbound calls to healthcare providers.
Accepting inbound calls from healthcare providers.
Answer questions about participation requirements, registration, assessment completion and scoring results.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. With over 66,000 employees, we combine scale, expertise and execution to create meaningful, measurable impact.
Manage initial credentialing and re-credentialing applications for physicians and mid-level providers across multiple U.S. states.
Complete and maintain CAQH ProView profiles, ensuring all provider data is accurate, current, and attestation-ready.
Submit and track payer enrollment applications with commercial insurance companies, Medicare, and Medicaid programs.
AMS Solutions is a leading medical billing and revenue cycle management company serving healthcare practices across the United States. They specialize in helping physicians maximize their revenue through expert billing, coding, credentialing, and practice management services.
Execute day-to-day provider enrollment, credentialing, and licensing tasks under guidance.
Input, maintain, and update provider data across databases and internal systems.
Review and process enrollment applications, supporting documentation, and status updates.
Allara is a women’s health provider that specializes in expert, longitudinal care that supports women through every life stage. Allara makes expert healthcare accessible by connecting patients with multidisciplinary care teams and is trusted by over 60,000 women nationwide.
Own end-to-end enrollment outcomes for your customer portfolio and be accountable for SLA performance and client satisfaction.
Manage an on/offshore team of enrollment specialists: set goals, build capacity plans and develop talent.
Identify and resolve root causes of client issues by coordinating cross-functional teams.
Medallion is a leading provider operations platform that eliminates administrative bottlenecks for healthcare organizations. They are one of the fastest-growing healthcare technology companies backed by $130M in funding from world-class investors, revolutionizing provider network management.
Own and grow strategic client relationships with large self-insured employers, translating healthcare claims data into actionable cost-saving strategies.
Lead client engagement cycles including regular check-ins, executive presentations, and strategic business reviews, collaborating with internal data science and clinical teams.
Oversee onboarding and implementation processes, coordinating with carriers and external data partners to ensure high-quality data intake and program enhancements.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They use technology to review applications and share top-fitting shortlists directly with employers, while the hiring company manages the final decision.
Build high-trust partnerships with the broker and consultant community.
Identify opportunities and fuel a high-quality pipeline for our Mid-Market and National Accounts.
Master consultative discovery and fast-track their path to a closing Account Executive role.
Rula is dedicated to treating the whole person and creating a world where mental health is embraced as an integral part of one's overall well-being. As a remote-first company, they strive to be a force for positive change in the field of mental healthcare.
Reconciles actual spend with payor 'Post Bundle' period end.
Hackensack Meridian Health helps patients live better, healthier lives. With a culture rooted in connection and collaboration, employees are team members and are supported to succeed.